CAMP Waiver & Information forms

Please fill out form here or you may download, complete and bring it on first day of camp.

CAMPER INFORMATION & LIABILITY FORM

Please fill out entire form for each child registered for Spring Break Skate Camp.

"*" indicates required fields

This field is for validation purposes and should be left unchanged.

Child's Name*

First Last

Child's Age*

Child's Birthday*

Parent's Name*

First Last

Parent's Primary Phone #*

Parent's Secondary Phone #

Emergency Contact Name*

First Last

Emergency Contact Phone*

Does your child have and limiting physical disabilities or handicaps (temporary or permanent)?*

YES

if YES, Please identify and explain:

Is there any additional information the RDN facilitator(s) should know that would assist us with providing a quality and safe experience?

Electronic Signature – Please provide the Name (First & Last) of Parent or Guardian*

*Required if Participant is under 18 years of age.

Date of E-Signature

Please provide today’s date

Additional Siblings (2)

Please check for additional sibling

Child's Name (2)*

First Last

Child's Age (2)*

Child's Birthday (2)*

Parent's Name (2)*

First Last

Parent's Primary Phone # (2)*

Parent's Secondary Phone # (2)

Emergency Contact Name (2)*

First Last

Emergency Contact Phone (2)*

Does your child have and limiting physical disabilities or handicaps (temporary or permanent)? (2)*

YES

if YES, Please identify and explain: (2)

Is there any additional information the RDN facilitator(s) should know that would assist us with providing a quality and safe experience? (2)

Electronic Signature – Please provide the Name (First & Last) of Parent or Guardian*

*Required if Participant is under 18 years of age.

Date of E-Signature

Please provide today’s date

CAMP Waiver & Information forms

CAMPER INFORMATION & LIABILITY FORM

Parties

Beginner Classes